Provider Demographics
NPI:1891702346
Name:HARRIS, KATHRYN P (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:P
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 E MARKET ST
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-1118
Mailing Address - Country:US
Mailing Address - Phone:302-644-9474
Mailing Address - Fax:302-644-9474
Practice Address - Street 1:207 E MARKET ST
Practice Address - Street 2:
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-1118
Practice Address - Country:US
Practice Address - Phone:302-644-9474
Practice Address - Fax:302-644-9474
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00000971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE648522Medicare ID - Type Unspecified